II. Field of the Invention
This invention relates to an apparatus which is used to anchor a nasogastric tube external to the nose. In particular, the apparatus employs an elongated flexible member which passes through one nostril, around the posterior nasal septum, and out the other nostril. The two ends of the flexible member, one passing out each nostril, are attached to a nasogastric tube or are affixed to an anchoring clip, to which also may be anchored a nasogastric tube. The invention also includes an apparatus and method for installing the elongated flexible member through the patient's nose to pass around the nasal septum.
II. Description of Related Art
In the medical treatment of patients it is common practice to use a nasogastric tube for entering the gastrointestinal tract of the patient by initially passing the tube into a nostril. While placement and operation of such tubes is quite common and effective, certain problems are recognized in the medical profession regarding efficient, safe and comfortable mounting or placement of such tubes, especially since such tubes are frequently maintained in their operative position for extended periods.
It is well recognized that conventional gastrointestinal tubes utilize securing means such as tape, sutures or complex headgear. The irritation and discomfort associated with such securement methods and devices may render many conventional devices unsuitable. A typical means for securing such a tube is to wrap adhesive around the outer surface of the tube and secure the same adhesive strip or material to the outer surface of the nose. This method is troublesome in that normal movement of the patient sometimes causes nasal septal ulcers and/or necrosis by causing excessive tube movement while the tube is in direct contact with an inner portion of the nose, such as when the tube is continuously repositioned or due to the normal movement of the patient.
Many conventional securing devices such as headgear or headband assemblies attempt to overcome problems of the type set forth above through the provision of specific anchoring or mounting structures. While operable for their intended function, numerous forms of these conventional devices have been found to be overly complicated or somewhat difficult or time consuming in their installation, maintenance or removal from the patient, thereby necessitating extensive nursing care for repositioning or readjusting the tube properly into its operative position.
The prior art consists primarily of tube anchoring devices which rely on adhesive means for connecting the anchoring device to the patient's nose, or which rely on some sort of strap encircling the head to hold the securing device in its proper position. Devices incorporating adhesive means include those described in patents issued to Liskody, U.S. Pat. No. 4,804,374, and Nowak, U.S. Pat. No. 4,932,943. Patents disclosing devices which utilize a strap around the patient's head include Hall, U.S. Pat. No. 4,284,076, and Coleman et al., U.S. Pat. No. 3,977,407.
Both adhesive and head-band type securements can be easily removed by a belligerent patient, and prolonged use of adhesive tape can cause skin irritation. Furthermore, it is possible for these securement devices to hold the tube too securely. Some amount of normal movement of the tube relative to the nose and nostril through which it enters is desired. However, excessive movement relative thereto is to be prevented so as to reduce the possibility of ulcers or irritation to portions of the nose, skin, etc. disposed in direct contact with the adhesive tape or tube.
The above discussion points out the need for a method to securely anchor a transnasal tube, such as e.g. a nasogastric tube, at the point where it exits the patient's body through a nostril. There is particular need for such a method which will effectively resist the efforts of an uncooperative or belligerent patient to withdraw or excessively move the tube, and which avoids the other problems associated with adhesive and headband type securements.